Lumbini Province exhibits the highest mortality rate among children under five years of age when compared to the seven provinces. As per statistical data, the national child mortality rate is in decline; however, the child mortality rate in Lumbini Province stands as the highest across the country.
The Nepal Demographic and Health Survey (NDHS) 2022 showed that the overall child mortality rate across the country was 3.3 percent. In a study conducted by the Ministry of Health and Population, focusing on child mortality at the provincial level, the data reveals that Lumbini Province has the highest child mortality rate among the seven provinces, standing at 4%.
According to statistical data, 40 children out of every 1,000 live births in Lumbini Province do not reach their fifth birthday. The study data states that the mortality rate of the newborn is 2.2% in the Lumbini province. Although the death rate of children under 5 years of age is high, the mortality rate of newborn babies is low in Lumbini Province.
The neonatal mortality rate in Sudurpaschim Province surpasses that of Lumbini Province, registering at 2.5%. Additionally, the mortality rate of children under 5 years in Sudur Paschim Province closely parallels that of Lumbini Province, standing at 3.9%. Likewise, in the Far Western Province, the mortality rate among children under five years is 3.9%, mirroring a similar rate observed in Lumbini Province. The Koshi region reports an infant mortality rate of 3.2%, with a corresponding neonatal mortality rate of 2%. Likewise, in Gandaki Province, the infant mortality rate is 3%, while the neonatal mortality rate is recorded at 1.8%.
Similarly, the infant mortality rate of Bagmati Province and Madhesh Province is equal to 1.9%, while the neonatal mortality rate is 0.9% in Bagmati Province. According to the data, the infant mortality rate in Madhesh Province is 1%, and all figures represent the number of deaths of children per thousand births.
The survey conducted by the Ministry of Health and Population in 2016 revealed that 39 infant deaths occur per thousand live births. In five years, the overall child mortality rate in Nepal has decreased by 6 %, but in Lumbini province, the child mortality rate has been increasing.
Health indicators are on a decline in Lumbini Province, despite its relative accessibility to health services, when compared to the Karnali and Sudurpaschim Provinces. Notably, Lumbini Province not only exhibits the highest child mortality rate but also records the highest maternal mortality rate in the country. In terms of access to health institutions, this province has prominent medical colleges and specialized province-level government hospitals. Geographically, it is relatively convenient to reach health institutions in comparison to certain other provinces.
According to Dr. Pushparaj Paudel, Consultant Shalakya physician at the Ministry of Health in Lumbini Province, recent observations indicate weaknesses in child and maternal health services. This is attributed to the inadequacy of policy plans and programs aligned with principles of equality and societal values. Factors such as women’s limited access to the decision-making process, injustices, prevalent child marriages, early childbirth, delayed hospital arrivals, and a shortage of skilled doctors are identified as the primary reasons for these challenges.
Dr. Paudel emphasized that their emphasis was solely on delivering health services, and they inadvertently neglected the critical aspect of service quality, a factor likely contributing to the emergence of these issues. He added In the future if this issue can be promoted as a cross-cutting issue, the child mortality rate and maternal mortality rate can be reduced. For this, all the concerned agencies, public representatives, health workers, communication workers, women health workers, and development partner organizations should identify the needs and carry out awareness programs.
In Kapilvastu, Bardiya, and Rolpa within Lumbini Province, the rate of institutional delivery is notably low, accompanied by a high infant mortality rate. Experts suggest that the rate of institutional delivery in Lumbini Province indicates a higher prevalence of health complications for women and newborns during delivery in private medical colleges and other private hospitals compared to government health institutions.
While overall statistics indicate a reasonable number of institutional deliveries in the province, the Lumbini province specifically exhibits a higher incidence of health complications during delivery in private medical colleges and other private hospitals for women and newborns compared to government health institutions. Consequently, there is a consequential issue in terms of infant mortality, newborn health, and maternal mortality. Experts emphasize the necessity for a comprehensive review and strategic progress in addressing these concerns.